NPI Code Detail Logo

1699903039 NPI Number Info

healthcare provider npi status:  active since 06/24/2009

MARIE ANTONETTE LOPEZ

Most Relevant Information

Provider Data

NPI Number 1699903039
Provider Name MARIE ANTONETTE LOPEZ
Entity Type Individual

Most Important Dates

Provider Enumeration Date 06/24/2009
Last Updated 06/26/2013

Provider Practice Location

12440 FIRESTONE BLVD #215
NORWALK
CA
90650-4328
US

Practice Location Phone/Fax

Phone 626-533-4153
Fax  

Provider Mailing Address

5621 TEMPLE CITY BLVD
TEMPLE CITY
CA
91780-2532
US

Mailing Location Phone/Fax

Phone  
Fax  

Authorized Official

Title or Position N/S
Authorized Official Name N/S
Credentials N/S  
Telephone Number N/S
Is it your NPI number ?

Detailed Information

NPI Number 1699903039 has the "Individual" type of ownership and has been registered to the following primary business legal name (which is a provider name or healthcare organization name) — MARIE ANTONETTE LOPEZ. Records indicate that the provider gender is "Female".

The enumeration date of this NPI Number is 06/24/2009.
NPI Number information was last time updated on 06/26/2013.

The provider is physically located at:

12440 FIRESTONE BLVD #215
NORWALK, CA
90650-4328, US

MARIE ANTONETTE LOPEZ can be reached at the following phone number(s):

Phone:  626-533-4153
Fax:  

The provider's official mailing address is:

5621 TEMPLE CITY BLVD
TEMPLE CITY, CA
91780-2532, US

The contact numbers associated with the mailing address are:

Phone:  
Fax:  

Scope of Practice (Taxonomy)

# Primary Taxonomy Code Taxonomy Specialty License Number License State
1 Y 225400000X Rehabilitation Practitioner

Reference NPI Information. Full Replica of the CMS (NPPES) NPI Record

Field Name Field Value
NPI 1699903039
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Individual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor Y
Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) LOPEZ
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Name MARIE
The first name of the provider, if the provider is an individual.
Provider Middle Name ANTONETTE
The middle name of the provider, if the provider is an individual.
Provider First Line Business Mailing Address 5621 TEMPLE CITY BLVD
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Business Mailing Address City Name TEMPLE CITY
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name CA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 91780-2532
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider First Line Business Practice Location Address 12440 FIRESTONE BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address #215
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name NORWALK
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name CA
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 90650-4328
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 626-533-4153
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date 06/24/2009
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 06/26/2013
The date that a record was last updated or changed.
Provider Gender Code F
The code designating the provider's gender if the provider is a person.
Provider Gender Female
The provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code #1 225400000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 Rehabilitation Practitioner
Healthcare Provider Taxonomy #1
Healthcare Provider Primary Taxonomy Switch 1 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.

Copyright © 2007-2026 Data Labs Health. All rights reserved.